Relationship between average vitamin D levels of European countries and COVID-19 case and mortality rates

Year 2022, , 127 - 134, 24.05.2022

Lütfiye Karcıoğlu , Zeynep Hatice Çöklü

https://doi.org/10.21673/anadoluklin.1019034

Cited By: 1

Abstract

Aim: The World Health Organization (WHO) data for Coronavirus Disease-2019 (COVID-19) revealed that the case and mortality rates due to Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) infection are higher in certain countries. Recent data have shown that various factors including the ratios of the elderly population and having chronic diseases, as well as vitamin D deficiency at different levels in populations, may be effective in this condition. It is recommended that vitamin D, known to be effective on the immune and respiratory system functions, should be used as a vitamin supplement with nutrients, especially in the risk group of elderly and chronic patients during the COVID-19 pandemic. The present study was conducted to determine the mean vitamin D levels and their correlations with COVID-19 cases and mortalities per million of each population of 20 European countries (Iceland, Norway, Germany, Sweden, Finland, Netherlands, Denmark, England, Ireland, Italy, Belgium, France, Switzerland, Spain, Estonia,
Czechia, Slovakia, Hungary Portugal, and Turkey).

Methods: A literature review was performed to determine the mean serum 25(OH)D levels of 20 European countries. It was evaluated statistically using the COVID-19 cases and mortality rates per one million population for the dates of November 22, 2020, and January 3, 2021, published by WHO.

Results: There was no significant correlation between the mean vitamin D levels and COVID-19 cases (p=0.08), while a moderately significant negative correlation was found with the COVID-19 mortality rates for 2020 (p=0.05).

Conclusion: Low vitamin D levels among European countries can explain 19% of COVID-19 mortality rates in 2020.

Keywords

COVID-19, infection;, SARS-CoV-2, vitamin D;, vitamin D supplements

Avrupa ülkelerinin D vitamini ortalama düzeyleri ile COVID-19 vaka ve mortalite oranları arasındaki ilişki

Abstract

Amaç: Dünya Sağlık Örgütü (DSÖ)’nün Koronavirüs Hastalığı-2019 (COVID-19) verileri incelendiğinde Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) enfeksiyonuna bağlı vaka ve mortalite oranları bazı ülkelerde daha yüksektir. Son araştırma verileri bu duruma yaşlı nüfus oranı, kronik hastalığa sahip olma gibi çeşitli etkenlerin yanı sıra popülasyonlarda farklı düzeylerde bulunan D vitamini eksikliğinin de etkili olabileceğini göstermiştir. İmmün ve solunum sistemleri fonksiyonları üzerinde etkili olduğu bilinen D vitaminini, COVID-19 pandemisi sürecinde özellikle risk grubundaki yaşlı ve kronik hastaların vitamin takviyesi olarak kullanmaları ve besinlerle desteklenmeleri önerilmektedir. Bu çalışma 20 Avrupa ülkesi (İzlanda, İsveç, Finlandiya, Norveç, Danimarka, Çekya, İngiltere, İrlanda, İtalya, Hollanda, Belçika, Almanya, Fransa, İsviçre, İspanya, Estonya, Slovakya, Macaristan, Portekiz ve Türkiye) ortalama D vitamini düzeylerini belirlemek ve her ülkedeki bir milyon nüfus başına düşen COVID-19 vaka ve mortalite oranları arasındaki ilişkiyi incelemek amacıyla yapılmıştır.

Yöntemler: 20 Avrupa ülkesinin ortalama serum 25(OH)D seviyelerini belirlemek için literatür taraması yapıldı. DSÖ’nün yayınlamış olduğu 22 Kasım 2020 ve 3 Ocak 2021 tarihlerine ait bir milyon nüfus başına düşen COVID-19 vaka ve mortalite oranları kullanılarak istatiksel olarak değerlendirildi.

Bulgular: Araştırmaya dahil edilen ülkelerin ortalama D vitamini seviyeleri ve COVID-19 vakaları arasında anlamlı bir ilişki yokken (p=0,08), 2020 yılına ait COVID-19 mortalite oranları arasında ise negatif yönde, düşük düzeyde (p=0,05) anlamlı bir ilişki olduğu bulunmuştur.

Sonuç: Avrupa ülkeleri arasında 2020 yılı COVID-19 mortalite oranlarının %19’u D vitamini düzeylerinin düşüklüğü ile açıklanabilmektedir.

Keywords

COVID-19, D vitamini, D vitamini takviyesi, enfeksiyon;, SARS-CoV-2

References

• Çakmak H, Yüksek YN, Tütüncü T, Küçük, EÖ, Turhan T, Berker D, Kahveci R. D vitamini testinin akılcı kullanımı: Test mi? Ya da tedavi mi? Turk J Clin Lab. 2018;10(2):168-78.
• Çalışkan Özçelik D, Koçer H, Kasım İ, Şencan İ, Kahveci R, Özkara A. D vitamini. Turkish Medical Journal. 2012;6(2):62-7.
• Zacharioudaki M, Messaritakis I, Galanakis E. Vitamin D receptor, vitamin D binding protein and CYP27B1 single nucleotide polymorphisms and susceptibility to viral infections in infants. Sci Rep. 2021;11(1):13835.
• Aleebrahim-Dehkordi E, Deravi N, Yaghoobpoor S, Hooshyar D, Rafieian-Kopaei M. The roles of vitamin D in increasing the body's immunity and reducing injuries due to viral infections: With an emphasis on its possible role in SARS-CoV-2 (COVID-19). Curr Pharm Des. 2021;27(44):4452–63.
• Teymoori-Rad M, Shokri F, Salimi V, Marashi SM. The interplay between vitamin D and viral infections. Rev Med Virol. 2019;29(2):e2032.
• Yalaki Z, Taşar MA, Öney H, Uslu Gökçeoğlu A. Akut bronşiyolit enfeksiyonu olan çocuklarda viral etkenler ile D vitamin düzeyinin karşılaştırılması. Çocuk Enfeksiyon Derg /J Pediatr Inf. 2019;13(1):14-9.
• Alipio, M. Vitamin D supplementation could possibly improve clinical outcomes of patients infected with Coronavirus-2019 (COVID-19). SSRN 3571484 [Preprint] 2020 [cited 2021 july 8].
• Grant WB, Lahore H, McDonnell SL, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020;12(4):988.
• Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9.
• Til A. Yeni Koronavirüs hastalığı Hakkında bilinmesi gerekenler. Ayrıntı Dergisi, 2020;8(85):53-7.
• Coronavirus disease (COVID 19) – World Health Organization [internet].Who.int. 2021 [cited 2021 July 8]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019?gclid=Cj0KCQjwxJqHBhC4ARIsAChq4atG4Y2ziNE-WuI4rHR2eipAT0xBFYH_y6dLzNWbTO-6KQi3ufAWv8MaAsYwEALw_wcB
• Dawson-Hughes B. Role of vitamin D in COVID-19: active or passive? J Clin Endocrinol Metab. 2021 7:505
• Ali N. Role of vitamin D in preventing of COVID-19 infection, progression and severity. J Infect Public Health. 2020;13(10):1373-80
• Lips P, Cashman KD, Lamberg-Allardt C, et al. Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. Eur J Endocrinol. 2019;180(4):23-54.
• Fidan F, Alkan BM, Tosun A. Çağın pandemisi: D vitamini eksikliği ve yetersizliği. Türk Osteoporoz Derg..2014;20(2):71-4.
• Pearce SH, Cheetham TD. Diagnosis and management of vitamin D deficiency. BMJ. 2010;340:b5664.
• Bergman P, Lindh AU, Björkhem-Bergman L, Lindh JD. Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS One. 2013;8(6):e65835.
• Şener A. COVİD-19 (SARS Cov-2) Tedavisi. J Biotechnol and Strategic Health Res. 2020;1(Özel Sayı):97-104.
• Trovas G, Tournis S. Vitamin D and COVID-19. Hormones. 2021;20(1): 207-8.
• Daneshkhah A, Eshein A, Subramanian H, Roy HK, Backman V. The role of vitamin D in suppressing cytokine storm in COVID-19 patients and associated mortality. MedRxiv. 2020.04.08.20058578.
• De Smet D, De Smet K, Herroelen P, Gryspeerdt S, Martens GA. Vitamin D deficiency as risk factor for severe COVID-19: a convergence of two pandemics. medRxiv. 2020.05.01.20079376.
• Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583.
• Tan CW, Ho LP, Kalimuddin S, et al. Cohort study to evaluate the effect of vitamin D, magnesium, and vitamin B12 in combination on progression to severe outcomes in older patients with coronavirus (COVID-19). Nutrition. 2020;79-80:111017.
• Ilie PC, Stefanescu S, Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clin Exp Res. 2020;32(7):1195-8.
• Raisi-Estabragh Z, McCracken C, Bethell MS, et al. Greater risk of severe COVID-19 in Black, Asian and Minority Ethnic populations is not explained by cardiometabolic, socioeconomic or behavioural factors, or by 25(OH)-vitamin D status: study of 1326 cases from the UK Biobank. J Public Health (Oxf). 2020;42(3):451-60.